The present invention relates generally to a support apparatus for a medical canopy and medical tubes, and more particularly, to such a support apparatus for use with an incubator/isolette bed and/or warming bed for a premature baby.
Medical patients occasionally have the need for a generally transparent canopy positioned over them to provide a sterile environment to protect them from potentially infectious airborne agents and to provide a controlled environment with temperature, moisture, oxygen, and like conditions best suited for patient skin and respiratory system treatment, function, and support. Such canopies are especially common for use with premature babies and other persons in serious condition. In such uses, canopies may be flexible or rigid and are typically provided with two openings, one for accepting standard sized tubes for providing the heat, moisture, and/or oxygen as is needed in a given situation and another opening for the exhaust of carbon dioxide produced by the respiring patient.
There are several situations in which it is extremely beneficial for a premature infant to be placed in a controlled environment under such a canopy. Infants commonly suffer from respiratory inflammations and/or maladies such as a sore throat, croup, and the like. In such cases, moisture may be provided in cooled or heated air through tubing and into the space formed under the canopy as desired to treat a given condition.
Another situation where a canopy is commonly employed is to provide oxygen therapy to an infant where there is a need for upper or lower respiratory support. In this situation, oxygen rich air is provided through the tubing to obtain and maintain the desired level of oxygen content in the air under the canopy. This method of oxygen therapy is preferable to the common alternative of using a mask covering the infant""s mouth and/or nose.
An additional common alternate is to provide nasal cannula inserted into the infant""s nose. This therapy is problematic, however, in that it tends to dry the mucus membranes of the nose even when providing humidified air through the cannula.
The method of creating an oxygen rich airspace under a canopy is preferable to the two alternatives just described because no uncomfortable tubes or mask are needed. The disadvantage to the oxygen rich environment method, however, is that the oxygen level of the air under the canopy fluctuates whenever the canopy is removed and reinstalled, or even merely disturbed, causing potentially severe physical distress to the premature infant. Conventional canopies must be removed for many routine matters requiring access to the infant such as examinations, repositioning blankets, pacifiers, and other comfort measures, and for any emergency situation.
Additionally, very low birth weight infants often experience a high degree of insensible water loss and heat loss as they have difficulty generating and maintaining adequate body heat because of their extremely small size and underdeveloped bodily systems. In such cases, heat and moisture may be provided through the tubing into the space under the canopy to create and maintain the desired temperature and humidity levels. However, removing and reinstalling the canopy causes fluctuations in the temperature and humidity of the air therein which can be distressful to the infant, as is the case with fluctuations in the oxygen level.
It is a common practice to place an infant under a canopy with controlled heat and moisture therein and with cannula tubes inserted into the infant""s lungs for oxygen therapy. Furthermore, there are other situations where infants and other medical patients commonly have tubes inserted into them, such as cannula tubes for draining fluids, intravenous tubes for supplying medication or nourishment directly into the blood, and the like. Such tubes are sometimes attached to a frame to secure the tubes in place and prevent entanglement and/or dislodgment caused by movement of the patient. It is therefore desirable in certain situations, particularly in the care of premature infants, to have available a flexible canopy support apparatus that also provides a tube support structure. While several known canopy support devices and several known tube support devices provide certain benefits, there remain a number of deficiencies in the art as discussed hereinbelow.
There are several known apparatus for supporting a drape over a medical patient. U.S. Pat. No. 3,530,515 to Jacoby provides a patient guard for use during surgery having an adjustable support loop for surgical protective sheeting and tubing. U.S. Pat. No. 4,377,112 to Whitt provides a surgical breathing apparatus having an adjustable support frame for surgical drapes and oxygen supply tubing. U.S. Pat. No. 4,321,917 to Campbell provides a surgical drape support and oxygen supply device having an adjustable support rod for a surgical drape and tubing. These apparatus are provided for use during surgery, generally on adults, and accordingly have specific mounting requirements for the supports and/or for attachment of oxygen lines or the like, and are not well-suited for use with a premature baby in an incubator bed or warming bed.
Also, there is a known pediatric aerosol tent provided by Ohmeda, Inc., providing a tent having access openings and supported by a tent support arm mounted on a stand. A cooling and moisture system is also provided and connected to the tent by tubing. This apparatus has several disadvantages with regards to use with premature infants. The tent support arm is stationary, such that for use with a warming bed, when the tent is moved away to one end of the tent support arm the arm can be an obstruction to doctor and/or nurses leaning over and attending to the infant. In practice, therefore, the entire apparatus is generally moved away to the side in order to access the infant. Additionally, the apparatus does not provide a support for cannula tubing. Furthermore, this apparatus is specifically designed for a large infant bed or crib for larger and more developed infants and is too large to use for newborn infants, as many may be very small, and which is especially disadvantageous for use in neonatal wards which may not be able to accommodate the larger beds. Because of the large size of the stand and support arm, the unit will not fit into and thus can not be used in conjunction with a conventional incubator or warming bed as used in neonatal wards. This lack of flexibility is a significant limitation to more widespread use of the apparatus.
There are also known tents, hoods, and canopies provided by Nova Health Systems, Inc., having rigid cuboidal shapes with built-in support frames. These framed canopies have several disadvantages. They provide a rigid frame with a fixed top and sides, generally having only one side that provides access to the infant. Because of the fixed sides, they are not adjustable and they provide only limited access to the infant when covered by the canopy. Because of the lack of adjustability of the rigid framed apparatus of Nova Health Systems, Inc., neonatal units generally must either stock a number of different sizes of the units to accommodate for small and large babies, or stock only one size which will then only cover a larger infants head and not its torso and lower body. Where units of multiple sizes are stocked, this disadvantage is compounded because these are single patient units discarded after being used by one infant, such that an entire new unit having a canopy and frame must be purchased for each infant instead of just a new canopy. Where only one size is stocked, the aforementioned disadvantage is compounded because the larger of these units do not fit easily inside conventional incubator beds, and the smaller of these units can not be used with many of the currently available tube supports commonly placed inside the canopy, as will be discussed in more detail hereinafter.
The aforementioned disadvantage of limited access to the infant results in difficulty in comforting, treating, and administering developmental care to the infant. It is becoming increasingly recognized by those experienced in the field that developmental care contributes significantly to the health and wellbeing of premature infants. Developmental care may include repositioning on a frequent basis the infant""s arms, legs, head, and torso to conform to the natural position in the mother""s womb. This is often accomplished by positioning developmental supports and aids such as blanket rolls and the like under or about the infant at specific positions to obtain the desired body position. It is generally acknowledged that such developmental care results in a more comfortable, more healthy, and more happy infant, with the consequence of a cost savings from such infants often being released from the hospital sooner and with few or no positional deformities. It is generally very difficult to administer such developmental care through only one end of the rigid cuboidal canopy of the apparatus provided by Nova Health Systems, Inc.
Moreover, such limited access to the infant results in a significant disadvantage in emergency situations, when an examination is conducted, or in routine situations where the rigid frame overly limits access and the canopy and frame must be repositioned or removed. In these instances, removing and reinstalling the canopy results in fluctuations in the otherwise controlled environment under the canopy thereby causing potentially severe distress to the infant as discussed hereinabove. Furthermore, when the canopy is removed, it must be placed somewhere, which is often on a chair or cabinet, and in emergency situations is sometimes the floor. This can result in cross-contamination of the canopy, raising the potential for serious infections in susceptible premature infants or requiring the frequent replacement of canopies thereby increasing costs.
With regards to supports for medical tubes inserted into patients, there are several known such apparatus. The apparatus provided by the U.S. patents to Jacoby, Whitt, and Campbell discussed heretofore all provide a surgical drape support that also supports tubes or has tubes integrally formed therein. These apparatus, however, are generally designed in size, shape, mounting, performance, and the like, for adults and for use in surgery. Furthermore, in the use of these apparatus, movement of the tubes causes movement of the drape support and vice versa.
Additionally, U.S. Pat. No. 5,387,177 to Dunn provides an adjustable pediatric incubator nest having a base and a pair of sidewalls with slits for securing tubes. U.S. Pat. No. 5,334,186 to Alexander provides a medical tubing and implement organizer having a tubing holder with generally cylindrical lateral bores for holding medical tubing, and a base with apertures to accommodate various medical implements and accessories. There is also a known halo tubing support provided by Nova Health Systems, Inc., having a base and a vertically adjustable circular or rectangular frame with tubing holder notches. These tube supports, however, generally have little adjustability and therefore can not be practically used with all canopies, thereby requiring buying and stocking tube support devices in multiple sizes. While these apparatus provide the benefit of being capable of use with many canopies and then the canopy removed when not needed, they do not themselves include a support means for a canopy.
Accordingly, what is needed but not found in the prior art is an apparatus for supporting and securing in place a flexible medical canopy and/or tubes for use with premature infants, the canopy support vertically adjustable and also detachable from the tube support, with the canopy and support allowing ready access to the infant without removing the canopy, and with the canopy and support being easily moved when necessary for full access to the infant such that the support is out of the way of the attendants and the canopy does not have to be placed to the side where it may become cross-contaminated.
Generally described, the present invention provides a support apparatus for a flexible medical canopy and tubes for use with an infant bed or the like, comprising a support stand having a generally flat base member and a generally vertical tube support member extending from the base member, the tube support member having an edge with a plurality of notches defined therein, and a canopy support member comprising a generally vertical member slidingly coupled to the tube support and a generally horizontal member hingedly attached to the generally vertical member. A canopy is preferably provided for draping over the canopy support, having access openings defined therein which provide access for attendants to reach into the canopy to comfort, reposition, and treat the infant, and typically having two openings for connecting tubes supplying oxygen, moisture and/or heat.
A first preferred embodiment of the present invention provides the support stand formed from a generally flat sheet of rigid material and having a generally C-shaped portion interposed between the tube support and the base. The tube support edge is in a spaced apart relationship with the base and defines generally a semicircle, triangle, quadrilateral, irregular shape, or combination thereof. The notches are generally semi-circular, and preferably at least one of the tube support notches has a larger radius than at least one other of the tube support notches.
The generally vertical member of the canopy support has an elongate adjustment member. Preferably, the elongate adjustment member has a slot defined longitudinally therein and the tube support has a slot defined therein, the slots having an overlapping portion in a longitudinally aligned relationship with each other permitting at least one fastener to be extended through the aligned slots. Alternatively, the elongate adjustment member has a releasable latch and the tube support has a generally vertical track with at least one catch surface, the track receiving the elongate adjustment member and the at least one catch surface operatively engaging the latch.
The vertical member has at least one first stop and the horizontal member has a bottom surface capable of being supported by the first stop such that the horizontal member may be supported in a generally horizontal first position above the base. The hinged mounting of the canopy support permits the horizontal member to be pivoted thereabout at least about 90 degrees. Preferably, the vertical member has at least one second stop and the horizontal member has a bottom surface capable of being supported by the second stop such that the horizontal member may be supported in a second position pivoted less than or equal to about 270 degrees from the first position. The horizontal member of the canopy support preferably has a quadrilateral shape with an opening defined therein.
A second preferred embodiment of the present invention provides the generally horizontal member of the canopy support comprising an elongate arm. At least one finger, and preferably two fingers, are pivotally mounted to the elongate arm to provide an adjustable wingspan for supporting different canopies of various sizes.
A third preferred embodiment of the present invention provides the canopy support if the first embodiment mounted onto a support stand that has an upright member similar to the tube support of the first embodiment. The upright member, however, is generally smaller and without notches for tubes.
Accordingly, it is an object of the present invention to provide an apparatus for supporting a medical canopy and medical tubes for use with an incubator bed, warming bed, or the like, with the canopy support detachable from the tube support so that the canopy support can be removed, folded, and stored in a compact space when only the tube support is needed, and with the canopy and tube supports vertically adjustable so that one apparatus can be used for most every application desired in a neonatal ward.
It is still another object to provide a canopy with generally sealable openings defined therein and an apparatus for supporting the canopy yet allowing access to the infant covered thereby such that doctors, nurses, and other attendants can reach through the openings into the canopy for comforting and developmental care of the infant without the necessity of removing the canopy and without significant interference in the environment under the canopy.
It is yet another object to provide the canopy and apparatus for supporting the canopy such that the support can be moved out of the way of attendants when the canopy must be removed, and such that the canopy continues to be carried by the moved support so that the canopy does not have to be detached from the support and placed to the side where it may become cross-contaminated.
It is a further object to provide the tube support arranged so that movement of the infant does not cause tension on the tubes and yet the tubes do not have so much slack as to become entangled.
These and other objects, features, and advantages of the present invention are discussed or apparent in the following detailed description of the invention, in conjunction with the accompanying drawings and the appended claims.